Removing a US President for medical disability falls
under Section 4 of the 25th Amendment of the US Constitution. This allows the Vice President and a majority of the Cabinet to declare the President unable to
perform duties. This makes the VP acting President. The President can contest
this, leading to a Congress vote where a two-thirds majority in both
houses is needed to uphold the removal.
This may mean it might only occur after the November 3, 2026 US Midterm Elections when Democrats may have large majorities
in Congress. This rarely-tested process, intended for severe incapacitation,
has never fully succeeded but has been discussed for situations where a
President is unfit but won't step down.
Frank George, Ph.D. @frankgeorge8675309 has written a fine article (below) about Trump.Dr Frank George is a psychologist and cognitive neuroscientist who proudly wears the scars of battle from two World Wars with Pathological Narcissists. He shares facts and personal insights to turn trauma into tactics and fear into fight.
The article is "The Most Dangerous Person In The
World Is Getting Worse” of January 5, 2026
at https://frankgeorge8675309.substack.com/p/the-most-dangerous-person-in-the
[Dr
Frank George's article continues] "This Could Have Been Prevented. We Have The
Knowledge. We Have The Influence. We Have The Voices. It's Time To Let The
Voices Speak.
When Will He
Be Stopped?
The new year
opened with a bang. Literally.
I don’t care
what you think about Maduro’s politics.
I don’t care
what you think about Trump’s politics.
This isn’t
about politics.
This is about
a dementing Malignant Narcissist wreaking vengeful havoc without concern or
consequence.
This is about
how long Congress, Courts, Governors, Mayors, and especially my fellow mental
health professionals are going to continue to sit around and not do shit while
their country, and next, their world, burns to the ground.
His actions
have political consequences, but they’re not political actions. He doesn’t care
about anything other than self preservation.
Protecting
his false self is his grand geopolitical strategy.
Why
Aren’t All The Voices Speaking Out?
Many
of us who work in mental health practice, education and research have known
about his condition for years. Some of us have been speaking out since his
first term and prior
to his second term. But it was too few to be heard loudly.
And,
some even objected, which made the battle harder. Why did some professionals,
who basically agreed with us, object to our voices?
The
Goldwater Rule was adopted by the American Psychiatric Association (APA) in
1973 to prevent psychiatrists from offering professional opinions about public
figures they had not personally examined or received consent from.
It
emerged following a controversy over psychiatrists publicly speculating about
Senator Barry Goldwater’s mental state during his presidential campaign in
1964, which led to a libel suit that cost the APA $75,000. The main motivator
appears to have been embarrassment and covering of the collective ass.
Historians generally agree the episode had negligible electoral impact.
When
people invoke the Goldwater Rule as if it were handed down on stone tablets, it
helps to remember what psychiatry looked like when it was written. In the 1960s
and 1970s, psychiatry was operating under the 2nd edition of the Diagnostic and
Statistical Manual (DSM-II).
A
60-year old ethics rule that is ending up doing more harm than good to the
Psychiatric profession, and to the world.
Back then, in
the DSM-II era and earlier, psychiatry and psychotherapy were purely subjective
and operating with shockingly loose boundary standards by today’s norms.
Sexual
relationships between psychiatrists (and other therapists) and patients were
not uniformly prohibited, were sometimes rationalized as “therapeutic,” and
were rarely enforced against.
Homosexuality
was still classified as a mental disorder.
Some
clinicians still thought sleeping with patients was “part of the process.”
Diagnostic
criteria were vague, impressionistic, and heavily psychoanalytic, i.e.,
Freudian. Evidence-based work barely existed, reliability between clinicians
was poor, and “diagnosis” often meant one psychiatrist’s gut feeling after a
short interview and a long cigar.
Fast-forward
to today, and the DSM-5. Today, we rely on longitudinal data, objective
analysis, behavioral observation, neurobiology, and population-level research.
We
routinely study personality structure, risk patterns, and psychopathology without
ever sitting across from the individual in question. That’s not
reckless — that’s how good science has evolved.
Pretending
that 1970s ethics rules map cleanly onto 21st-century biological, psychological
and socio-cultural science is wrong.
It
isn’t caution.
It
isn’t ethics.
It’s
chicken shit.
Critics
point out that such a rule, rooted in a specific political episode and
mid-20th-century clinical norms, has not kept pace with the scientific
advancements in observational
assessment, digital behavioral data, and contemporary understandings of
clinical judgment — McCloughlin, 2021.
✅ Oh, The Irony
There
is a deep historical irony embedded in the Goldwater Rule. Barry
Goldwater was not an authoritarian populist. In the 1980s and 1990s,
he repeatedly warned that the growing influence of the religious right and
populism posed a serious threat to democracy, famously criticizing leaders who
sought power through grievance, moral absolutism, and mass emotional
manipulation.
He’d
likely be horrified to see his party not based on ideology but on dominance,
spectacle, and loyalty tests.
The
irony is tragic: a rule created to protect public figures from reckless
psychiatric speculation ended up muting responsible psychological commentary.
That
silence helped normalize the rise of disordered personalities that earlier
clinicians would have warned about en masse.
If
there is a “laughing in his grave” moment, it’s this:
the
man who was questioned as being unfit became the namesake of a rule that later
constrained warnings about it.
For
over forty years the rule faced few challenges until Trump’s election in 2016.
Since then, a significant number of psychiatrists and psychologists have either
violated, criticized or ignored the rule. But not enough.
Whatever
the initial merits, they have since been rendered obsolete by:
1. the combined lack of professional consensus
2. absence of a meaningful enforcement mechanism
3. credible statements of non-APA members in the mental health
professions regarding public figures.
— Appel and
Michels-Gualtieri, 2021
4. peer-reviewed and professional commentary directly criticizing the Goldwater
Rule as outdated, overly restrictive, and based on assumptions about
clinical judgment that don’t hold up in our modern era of massive, immediate,
credible data.
In
fact, one writer came right out and said:
“psychological
scientists with suitable expertise may harbor a ‘duty to inform,’ allowing them to offer informed opinions concerning
public figures' mental health” Lilienfeld,
et.al., 2013
✅ Speaking Out
In
spite of the obvious shortcomings and antiquity of the rule, it’s still adhered
to by a strong majority of Psychiatrists. It doesn’t ethically bind Clinical or
other Psychologists, but it’s easier to follow along than to create a tussle. I
see this as an example of Arendt’s “Banality
of Evil.”
A
few colleagues and I have been routinely speaking out. I’ve been supported by
hundreds of positive comments and discussions from other colleagues.
I’ve
only been attacked a couple of times by bloviating MDs hiding behind their APA
membership.
I
have just one thing to say to them: “Go crawl into a hole, preferably the one
in Trump’s ass, because you helped make him what and where he is today.”
But
get this, I’ve engaged politely with them and they haven’t argued against what
I’m saying. They only disagree with me saying it.
Seriously?!?
We’ve
let loose on the world an unhinged Malignant Narcissist and I should shut up?!?
You
know, my respected colleagues in Psychiatry, Clinical Psychology, Cognitive
Neuroscience, Neurology, and several other areas make up tens of thousands of
voices that could be shouting every day to remove this terror from our lives.
But,
still, several years later, only a few have done so.
This
needs to change.
The
mental health field still has the power, right here, right now to stop this
before it’s too late. I know you’re out there. Who wants to join? Who wants to
speak out?
Strategy
& Tactics: How Not to Get Psychologically Dragged Into the Storm
When
pathological or malignant narcissism escalates, the danger isn’t only what the
narcissist does.
It’s what
happens to everyone else’s nervous systems.
Fear,
outrage, exhaustion, fixation, and hopelessness become contagious.
So the most
important form of resistance isn’t political.
It’s
psychological.
🧠 Here are
evidence-based strategies for staying grounded when the environment is
destabilizing.
1. Name the
Pattern — Don’t Argue With It
One of the
most stabilizing acts is simple pattern recognition.
When you
understand that:
escalation is
defensive
spectacle is
self-preservation
aggression is
Freudian displacement
you stop
asking, “Why would anyone do this?” and start thinking, “Ah. This is that
pattern again.”
That shift
matters. It pulls you out of emotional reactivity and back into cognition.
You don’t
have to approve.
You don’t
have to excuse.
You just have
to see clearly.
Clarity is
grounding.
2. Refuse the
Nervous-System Hijack
Narcissists
thrive on hijacking attention and emotion. Rage, panic, doomscrolling, and
compulsive checking are what they want.
From a
self-regulation standpoint, this means:
limit
exposure without disengaging from reality
choose when
you consume information
notice bodily
activation before mental spirals
If your heart
rate is up and your shoulders are tight, you’re no longer “informed” — you’re
activated. That’s your cue to pause.
Calm is not
complacency.
Calm is
resistance to manipulation.
3. Stay in
the Long Timeline
Narcissistic
escalation collapses time.
Everything
feels urgent. Apocalyptic. Now-or-never.
One of the
most powerful stabilizers is deliberately widening your temporal lens:
history has
endured worse
long lasting,
good change happens slowly
You don’t
need to emotionally live in the next headline. You can live in your actual day.
That alone
reduces anxiety dramatically.
4. Anchor to
What You Can Control (Which Is More Than You Think)
Narcissists
make people feel small and helpless.
Reclaim
agency by anchoring to:
daily
routines
body-based
regulation (sleep, movement, food)
meaningful
work
human
connection
values-driven
action at a local scale
You don’t
need to fix the world to stay sane in it.
You need
structure, meaning, and agency.
6. Build
Psychological Endurance, Not Just Awareness
Insight alone
doesn’t regulate a nervous system.
This is where
practical tools matter: structured reflection, grounding exercises, values
clarification, and daily moments that help people stay oriented when the world
feels loud and hostile.
That’s the
space my workbook, Staying Positive in a Negative World, was designed for — not
as a denial of reality, but as a step-by-step way to stay psychologically
intact inside it. It’s about building internal scaffolding so external chaos
doesn’t become internal collapse.
The solution
is resilient clarity.
If you
enjoyed this article, please like, share, and restack. It makes a difference."
Ends